Facing Health Care Obstacles?
SAN FRANCISCO - Lack of insurance or timely access to your regular doctor doesn't have to mean going without needed health care.

If you're uninsured and seeking stop-gap medical care before you find coverage again, you can triage your way to better health by understanding the trade-offs of several care options, experts say. A retail clinic, urgent-care or community health center may be a suitable fit, depending on the severity of your medical need and your personal preferences.

Still, a shortage of primary-care physicians has left many scrambling to keep up with patient demand. The wait time for appointments can be a deal-breaker, forcing patients to look elsewhere for care.


Convenience and expense are two reasons uninsured patients who suspect they have a routine, minor ailment such as the flu, strep throat, simple bronchitis or a skin condition should consider visiting a retail clinic, Mehrotra said.

Retail clinics also typically offer vaccinations and physicals for school, camp or sports on a walk-in basis, and they're open evenings and weekends. They're located in national chain stores such as Walgreens and CVS/pharmacy as well as hospital systems. They're staffed by nurse practitioners or physician assistants who can diagnose, treat and prescribe medication.

Unlike emergency rooms and other health-care settings where there's no way to know how much the final bill will be, retail clinics post their prices on a menu board and often online.

Patients "know exactly what they're going to pay," Mehrotra said.

CVS/pharmacy stores, for example, have 500 MinuteClinics in 25 states. They're all open seven days a week and have weekday evening hours, and the average cost of treatment is $62, said Andrew Sussman, president of MinuteClinic, based in Minneapolis.

"It's Sunday morning and your 10-year-old has a sore throat and a fever," Sussman said. "We're a good option for people."

Retail clinics offer a quality of care equivalent to that of urgent-care centers and private doctor's offices, according to a 2009 study from Rand Corp. Its typical patients are young adults with no regular health-care provider.

Limitations: Patients looking for a doctor or on-site X-ray or lab facilities won't find them at retail clinics, and many won't treat babies and toddlers younger than 18 months.


For care that's more comprehensive care than at retail clinics but not as complete as in hospital emergency departments, urgent-care centers are an option.

They also don't take appointments but offer doctors and treatment for mid-level problems such as simple fractures, sprains, bruises, burns and cuts requiring stitches. Many also treat asthma and bladder infections.

"Our goal is to get people in, treated and out within an hour," said Jim Greenwood, chief executive of Concentra, a Dallas-based health-care and wellness provider that owns and operates more than 300 urgent-care clinics in 40 states.

"We're not battling the primary-care doctors," he said. "We're supplementing what they do."

Transparent pricing also has caught on at Concentra, which shows in English and Spanish the cost of three levels of service, which typically range from $95 to $190, Greenwood said.

Concentra's urgent-care centers are located closer to where people work than where they live, and many have extended hours to accommodate people's work schedules. Back pain is one of the top reasons patients seek care there, and each center is staffed with a doctor and a physical therapist, Greenwood said.